The Stupp protocol has become the standard of care for the treatment of high-grade astrocytoma and glioblastoma since its publication in 2005 and has led to significant survival improvements 1. It consists of radiation therapy and concomitant chemotherapy with temozolomide, an alkylating agent.
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Protocol
According to the original study, the Stupp protocol comprises:
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radiation therapy
total 60 Gy
2 Gy per daily fraction (Monday to Friday) over 6 weeks
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during radiation therapy: 75 mg per square meter of body-surface area per day, 7 days per week
post-radiation therapy (adjuvant): 6 cycles consisting of 150-200 mg per square meter for 5 days during each 28-day cycle
Prognosis
This therapy resulted in a significant survival improvement at 2 years:
26.5% 2-year-survival with Stupp protocol
10.4% 2-year-survival with radiation therapy alone
A substantial minority of patients can demonstrate changes of pseudoprogression on follow-up imaging.
History and etymology
The Stupp protocol is named after Roger Stupp the first author of the 2005 paper, who is a Swiss oncologist working out of Northwestern University School of Medicine, previously the University of Zürich 1.